Texas Attorney General Ken Paxton has filed a lawsuit against Children’s Health System of Texas and Dr. Jason Jarin, accusing them of violating state law by providing sex-transition-related treatments to minors after the enactment of Senate Bill 14.

The 2023 law bans puberty blockers, cross-sex hormones, and related medical interventions for individuals under 18 for the purpose of gender transition. According to the lawsuit, Dr. Jarin and the hospital system continued prescribing such medications after the law took effect on September 1, 2023.

The complaint alleges that Dr. Jarin billed males for medications classified as birth control that were allegedly intended for cross-sex estrogen use, used improper diagnostic codes when seeking reimbursement, and prescribed puberty blockers under diagnoses such as precocious puberty. Puberty blockers are approved by the Food and Drug Administration for early-onset puberty but are not approved for treating gender dysphoria.

Paxton accused the defendants of defrauding state insurance programs, including Medicaid, and attempting to circumvent SB-14 through what the lawsuit describes as a “wean protocol.” Under that protocol, patients who began treatment prior to June 1, 2023, could gradually taper off medications over what the state claims was an extended timeline of two to five years. The lawsuit contends the protocol allowed minors to continue experiencing the effects of cross-sex hormones until they reached adulthood.

The state further alleges that certain “exceptions” permitted some patients to discontinue weaning altogether if hormone levels were not maintained at specified thresholds or if mental health documentation was incomplete. Paxton argues there was no legitimate medical basis for maintaining opposite-sex hormone levels long term and claims the protocol functioned as a workaround to state law.

The lawsuit asserts violations of the Texas Health Care Program Fraud Prevention Act and the Texas Business & Commerce Code, and alleges that Dr. Jarin knowingly violated SB-14 in at least twelve cases involving minors.

Children’s Health said in a statement that it complies with all applicable local, state, and federal healthcare laws and declined further comment due to ongoing litigation. UT Southwestern Medical Center, where Dr. Jarin serves as an associate professor, did not immediately respond to requests for comment.

The case could potentially draw federal scrutiny due to allegations involving Medicaid billing, though no federal agency has announced involvement at this time.